Paediatric head and neck cancers in Nigeria: implications for treatment planning in resource limited settings

Background: The head and neck (H/N) is a common site for childhood cancers. This study examined all cases of H/N childhood cancers diagnosed in a major teaching hospital in Nigeria over 18 years to determine patterns of broad lineage cancer groups. Materials and Methods: Primary pediatric childhood malignancies diagnosed between 1990 and 2008 were analysed. Logistic regression models were fitted to determine significant clinical correlates of childhood cancer. Results: Lymphomas were the commonest cancers (49.5). After controlling for site and age; there was no significant difference in the incidence of Burkitt's lymphoma (BL) by sex ( P=0.423). The jaw bones (mandible and maxilla) were the commonest sites in the H/N for involvement of BL; with over 20 times the odds of occurrence when compared to other non-jaw sites of the H/N region (Adjusted Odds Ratio [AOR]=21.41; P0.001). Among the jaw bones; there was no significant difference in the occurrence of BL ( P

Presentation of Colorectal Cancers in Benin-City; Nigeria

Background: Colorectal cancer is a major cause of cancer death worldwide; and the prevalence in Nigeria appears to be increasing due to a shift to western diets. We undertook a retrospective analysis of colorectal cancers seen at the University of Benin Teaching Hospital; Benin City from January 1983 to December 2002. Methods: One hundred and two cases involving the large bowel were encountered. These were analysed for age; sex; site; histological type and clinical features. Results: The mean age was 44.5 +/-4.5 years. Males accounted for 56 (54.9) cases; while 46(45.1) were females. Seventy two (70.2) of the tumours were located in the rectum. Adenocarcinoma was the predominant histological type; with 89 (87.2) cases. Fifty two (51) cases presented with intestinal obstruction. Conclusions: Conclusion; colorectal cancers are not rare in our environment as previously believed; though; the frequency in Benin City is relatively low

Surgical Anatomy of the Vertebrobasilar Territory and Posterior Circle of Willis

BACKGROUND: In the present era of microscopic and neuroendoscopic procedures; the surgical anatomy of the skull base vessels has gained increased significance. The pattern of the vertebrobasilar arterial complex and the posterior circle of Willis (COW) in Nigerians has not been previously reported despite various variants of these complexes existing in different populations. OBJECTIVE: To review and document the size; distribution and anomalies of the vertebrobasilar territory and posterior COW pattern in a Nigerian set of brains. Methods: The target population for this study was a group of Nigerian adults 18 years and above. Specimens from patients with an ante-mortem or post-mortem evidence of meningitis or atherosclerosis were excluded. The size; distribution and anomalies of the vertebrobasilar artery; its branches; and the posterior COW were defined in 50 brains. RESULTS: The male: female ratio was 1.9:1 and a mean age of 44 years. Statistical analysis showed significant differences between the sizes of posterior inferior cerebellar arteries and anterior inferior cerebellar arteries (Student's t = -30.189; p-value = 0.000). Fifty-six percent of the brains had no anomalies. Thirty anomalies were noted in posterior COW compared with six in the vertebrobasilar territory. There were no aneurysms in all the specimens studied. CONCLUSION: Anomalies in the region of the posterior COW are commoner than the vertebrobasilar territory and the region of the posterior communicating artery is the most common site of anomalies in the posterior COW territory. These variations should be taken into account during skull base and carotid surgeries; and cerebral angiography

Diethylene glycol poisoning in Nigerian children

Clinical and pathological features in 23 children who developed acute renal failure from what was subsequently proven to be diethylene glycol poisoning are presented. Symptoms of cases included anuria; fever; diarrhoea and vomiting. Eighteen (78.3) had hepatomegaly; 11(47.8) had evidence of respiratory distress and 7 (30.4) had acidotic breathing. Seven (30.4) of the children were dehydrated on physical examination. Alteration in the level of consciousness was observed in 13 (56.5) children. The major biochemical abnormalities were acidosis and elevated blood urea nitrogen. Although serum bilirubin was normal in those in whom it was determined; the liver enzymes were elevated in the 2 patients in whom they were determined